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Acute delirium as an initial manifestation of COVID-19 patients with acute ischemic stroke: Report on two cases.
Huang, Jin-An; Chen, Wen-Hsien; Liao, Nien-Chen; Wu, Chieh Liang; Fu, Yun-Ching; Chen, Po-Lin.
  • Huang JA; Division of Neurology, Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Health-Business Administration, Hungkuang University, Taichung, Taiwan.
  • Chen WH; Department of Radiology, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Industrial Engineering and Enterprise Information, Tunghai University, Taichung, Taiwan; Department of Medical Imaging and Radiological Sciences, Central Taiwan University of Science and Technology, Taichung
  • Liao NC; Division of Neurology, Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Critical Care Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
  • Wu CL; Department of Critical Care Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
  • Fu YC; Deputy Superintendent, Taichung Veterans General Hospital, Taichung, Taiwan.
  • Chen PL; Division of Neurology, Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan; Institute of Brain Science, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan. Electronic address: boringtw@gmail.com.
J Formos Med Assoc ; 121(8): 1605-1609, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-1739928
ABSTRACT
Psychiatric and neurological complications of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are common. Psychiatric symptoms are so common that they are easily misinterpreted as an affective disorder induced by SARSCoV-2 infection. However, psychiatric symptoms, such as acute delirium, though rarely seen, can be the initial manifestations of acute ischemic stroke (AIS). These psychiatric symptoms may confuse the diagnosis of acute stroke, which needs correct and timely management. We report two hospitalized cases with SARS-CoV-2 infection and elevated serum D-dimer levels having acute delirium as the initial manifestation of AIS. The diagnostic processes were challenging and time-consuming, so reperfusion therapy could not be given in the therapeutic time window. The diagnoses of AIS were finally made by brain magnetic resonance imaging which showed diffusion restriction at the right middle cerebral artery territory in both cases. Features of psychiatric complications and stroke in coronavirus disease 2019 (COVID-19) patients are reviewed. For the hospitalized COVID-19 patients with elevated levels of serum Ddimer and acute delirium, acute stroke with neuropsychiatric manifestations should beconsidered.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Stroke / Delirium / Ischemic Stroke / COVID-19 Type of study: Case report / Diagnostic study Topics: Long Covid Limits: Humans Language: English Journal: J Formos Med Assoc Journal subject: Medicine Year: 2022 Document Type: Article Affiliation country: J.jfma.2022.01.025

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Stroke / Delirium / Ischemic Stroke / COVID-19 Type of study: Case report / Diagnostic study Topics: Long Covid Limits: Humans Language: English Journal: J Formos Med Assoc Journal subject: Medicine Year: 2022 Document Type: Article Affiliation country: J.jfma.2022.01.025